AB0109 ASSESSING PREVALENCE OF SPONDYLOARTHRITIS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE: AN ANALYSIS OF RETROSPECTIVE DATA FROM A NOVEL COMBINED RHEUMATOLOGY AND GASTROENTEROLOGY CLINIC
Authors: U. Dhamrah, S. M. Lao, A. Bhattacharya, B. Moghaddam
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Spondyloarthritis (SpA) associated with inflammatory bowel diseases (IBD) is a subtype of SpA affecting the axial spine (AxSpA) and peripheral musculoskeletal system causing arthritis, enthesitis and dactylitis (peripheral SpA) in patients with Crohn's Disease (CD) or Ulcerative Colitis (UC). The prevalence of SpA in IBD is variable but reported to range from 5-15% for axial SpA and 30-45% for peripheral SpA. Detection of SpA in IBD patients requires a multidisciplinary approach to ensure early diagnosis and tailored treatment. This highlights the need for combined assessment by rheumatology and gastroenterology to prevent disability and loss of function. <h3>Objectives</h3> We aimed to assess the prevalence of SpA in IBD patients evaluated for arthralgia in a combined gastroenterology and rheumatology clinic (IB-DART), in a large tertiary care center in New York City. <h3>Methods</h3> We conducted a retrospective chart review of patients with IBD and arthralgia who were evaluated by physicians of both specialties in the IB-DART clinic. Patients over the age of 21 with a diagnosis of IBD and symptoms of joint pain were included. A multidisciplinary approach was taken for both diagnosis and treatment. Prevalence of axial SpA, peripheral SpA, HLA B27 positivity were calculated. Descriptive statistics were used. <h3>Results</h3> 63 patients (61.9% females) were seen in the IB-DART clinic, the average age was 48.5. There were 10 (15.8%) patients with non-inflammatory arthritis and 53 (84.1%) patients with axial or peripheral SpA. Of the 53 patients, 7 (13.2%) had AxSpA, 32 (60.3%) had peripheral SpA, and 14 (26.4%) had both axial and peripheral SpA. SpA was seen in 90.9% of the 44 CD patients, 68.7% of the 16 UC patients, 66.6% of the 3 undifferentiated IBD patients. 9 (42.8%) patients with AxSpA were found to have x-ray and MRI evidence of sacroiliitis. 1 had MRI findings of enthesitis. HLA B27 was only positive in 3 of the 39 tested patients and did not correlate with axial or peripheral involvement. In patients with SpA, 23 were on TNF inhibitor therapy, 10 on JAK inhibitors, 13 on interleukin-12/23 inhibition, and 6 on conventional DMARDs (ie Methotrexate, 6MP, hydroxychloroquine) and prednisone. (Table 1) <h3>Conclusion</h3> We report a high prevalence of IBD associated SpA in patients presenting for evaluation of arthralgia to a multidisciplinary clinic. Diagnosis and management of SpA in the context of IBD can be challenging and warrants a multidisciplinary approach to timely diagnosis and management. Combined efforts to make treatment changes to induce and maintain disease remission can lead to improvement in morbidity in these patients. This study highlights the characteristics of patients with IBD associated SpA and demonstrates the value of integrated management in clinical practice. <h3>References</h3> [1]de Vlam K, Mielants H, Cuvelier C, De Keyser F, Veys EM, De Vos M. Spondyloarthropathy is underestimated in inflammatory bowel disease: prevalence and HLA association. <i>J Rheumatol</i>. 2000;27(12):2860-2865. [2]Orchard TR, Wordsworth BP, Jewell DP. Peripheral arthropathies in inflammatory bowel disease: their articular distribution and natural history. Gut. 1998;42(3):387-391. doi:10.1136/gut.42.3.387 [3]Malaty H, Lo G, Hou J. Characterization and prevalence of spondyloarthritis and peripheral arthritis among patients with inflammatory bowel disease. Clinical and Experimental Gastroenterology. 2017;Volume 10:259-263. doi:10.2147/ceg.s136383 <h3>Acknowledgements</h3> I have no Acknowledgements to declare. <h3>Disclosure of Interests</h3> None Declared.